Special Report: Take action against breast cancer

October is Breast Cancer Awareness Month, the annual international campaign to raise awareness and funding for research towards a cure for a disease that affects one in eight women (close to 12 percent) in the U.S. While more than 3 million American women have a history of breast cancer, 85 percent of cases occur in women who have no family history of the disease.

In 2017, the American Cancer Society estimates that 255,180 women and men will be diagnosed with invasive breast cancer, with more than 41,000 cases becoming fatal. For women in the U.S., breast cancer is the most commonly diagnosed cancer besides skin cancer — and death rates for breast cancer are higher than for any other cancer besides lung cancer.

However, it’s possible to reduce the risk of developing breast cancer through monthly self-examinations, and consulting doctors or physicians about any physical changes or abnormalities. The National Breast Cancer Foundation recommends a clinical breast exam performed by a qualified medical professional once every one to three years beginning at age 20, and annually beginning at age 40. The American Cancer Society also recommends yearly screening mammograms starting at age 45.

Be on the lookout for warning signs or potential symptoms of breast cancer, such as a lump in the breast or changes in breast tissue or skin. Healthy lifestyle choices, such as managing weight and being physically active, limiting your intake of alcohol, not smoking, and avoiding exposure to environmental pollution and radiation can help to minimize your risk, according to the Mayo Clinic.

“This year and moving forward, the focus is about taking action beyond just awareness and being more than pink,” said Amanda Stevens, executive director of Susan G. Komen Hawaii. “It’s important that women know their whole bodies, from lymph nodes to breast and chest. If you feel different, speak to your physician.”

For the past 23 years, Susan G. Komen Hawaii has served the local community by providing resources and raising money through events, such as their annual Race for the Cure. Of the funds raised, 25 percent goes towards cancer research and 75 percent stays in Hawaii. In 2016, Komen was able to grant a combined $200,000 to organizations that provide medical screenings and diagnostic or treatment services on Oahu, Lanai, and Maui, including Castle Medical Center’s Breast Health Patient Navigation and Wellness Program, Kalihi-Palama Health Center’s Health Center Breast Screening Program, and Waimanalo Health Center’s Malama I Ke Ola O Na Wahine project.

Small grants of $10,000 or less are also awarded on a rolling basis; for example, Hawaii nightlife promoter Christa Wittmier recently received funding to help complete a documentary film about her own struggle with metastatic breast cancer.

“I’ve spent the last two years shooting and developing the story, it follows my integrative approach to taking on Stage IV breast cancer,” Wittmier said. “We really needed $30,000 for post-production costs, but my team was happy to walk away with $20,000 from Kickstarter. This grant was able to get us to the goal we set and will help us push this story forward.”

In Hawaii, Kaiser Permanente leads more clinical trials for cancer than any other hospital. Combined with access to clinical trials from all other Kaiser Permanente areas, which extends to 18,000 physicians practicing at 38 hospitals across eight states and Washington D.C., Kaiser Permanente Hawaii is able to offer patients the latest in new information and treatment options emerging from advances in oncology.

“Breast cancer is a growing and ever-changing field,” said Dr. Jennifer F. Carney M.D., Kaiser Permanente Hawaii chief of hematology and oncology. “There have been a lot of trials we have here that are looking at reducing endocrine or estrogen resistance, we have targeted therapies against specific breast cancers, like HER2 or triple-negative cancer. We believe that all our standards of care should come from clinical trials and be evidence-based.”

Their result is a cumulative approach to treatment. At Kaiser Permanente Hawaii’s breast care clinic, a support staff of surgeons, oncologists, radiologists, geneticists, and other specialists are all gathered under one roof to carry out a comprehensive plan on-site.

“We have a dedicated breast care team of specialists that can follow up on all abnormal imaging within a very timely fashion. Not only do we do a same-day breast cancer review of pathology results, but then we also meet the patient right after. They’ll have, by the end of the day, the date of their surgery scheduled, or if they need any more follow-up [appointments],” Carney said.

At Hawaii Pacific Health, Director of Oncology Services Elizabeth Blasiak reminds patients to always follow up with physicians as a preventative measure. “Even if you’re feeling okay, it’s important to have regular checkups with your primary care provider or OBGYN,” Blasiak said. “With most cancers, there isn’t often screening technology but with mammograms, we can find breast cancer early.”

Hawaii Pacific Health offers four specially focused women’s centers: Kapiolani, Pali Momi (both breast cancer programs are nationally accredited), Straub Medical Center on Oahu, and Wilcox Medical Center on Kauai. The not-for-profit health care network also offers a High Risk Breast Program for women considered to have an elevated risk for breast cancer due to family history or a previous diagnosis. The intensive surveillance program includes imaging services, genetic testing, education on early detection methods, and chemoprevention.

“I’m really proud of our High Risk Breast Program because we can provide early care for women before they actually have cancer,” Blasiak said. “That’s another service we offer at all four of our centers.”

Another health center benefitting from a partnership with a network of leading medical facilities is The Queen’s Medical Center, which in 2015 became the first hospital in the state to work with MD Anderson Cancer Network, a program of the University of Texas. In a “Best Hospitals” survey by U.S News & World Report, MD Anderson Cancer Center came in as the No. 1 cancer center in the U.S.

As a certified member of MD Anderson, Queen’s physicians are able to utilize evidence-based guidelines, protocol, and treatment plans developed by this distinguished cancer facility. The American College of Surgeons’ Commission on Cancer recently bestowed the Queen’s Cancer Center with the Outstanding Achievement Award, an honor given only to a select group of 75 accredited cancer programs across the United States.

Queen’s is also home to a specialized Native Hawaiian Health Program, which examines health disparities specific to Native Hawaiians, to address the gap in care and health status between this population and other ethnicities in Hawaii.

When Diane Paloma, a 20-year veteran of the health care industry, was diagnosed with breast cancer, she came to Queen’s. “What was most striking to me was that I was a young, Native Hawaiian female who had been diagnosed with the very thing that I [worked] almost every day to try and prevent,” Paloma said. “I was able to look at the other side of it and become the patient. I learned so much.”

After her diagnosis in August 2014, Paloma underwent a bilateral mastectomy and subsequent reconstruction at the Queen’s Medical Center. Her journey took close to nine months. “My surgery was [three] years ago, then I think about how many surgeries have gone on since I stepped into that OR and it’s amazing,” Paloma said. “It’s very sobering to think of how many people will end up getting cancer, but it’s reassuring at the same time to know that there are places here in Hawaii [for treatment]. You don’t have to fly to the Mainland, you can come here and know that you’re receiving the best possible care.”

For those afflicted with breast cancer, health centers such as Kaiser Permanente, Hawaii Pacific Health, and The Queen’s Medical Center offer state-of-the-art technologies and treatment options administered by top specialists and physicians. According to Dr. Carney of Kaiser Permanente, Hawaii boasts among some of the highest survival rates of all states for breast cancer.

“We believe that where you live does not determine if you should live,” said Susan G. Komen Hawaii Executive Director Amanda Stevens. “Whether you’re uninsured, underinsured, or if you have a pre-existing condition, we believe every single human being deserves an excellent quality of health care.”